Form CRF5: Catchment Restoration Fund for England –Final statement of account

Catchment Restoration Fund for England –
Final statement of account

CRF5 Version 1, June 2012page 1 of 4

Form CRF5: Catchment Restoration Fund for England –Final statement of account

This form should be completed as soon as possible and no later than the end of the first complete financial year following the date of substantial completion of the works (evidence on the project completion form CRF8).

The project completion form CRF8 should be submitted once the project has been completed. If it has not been submitted, please complete it and send it to us with this form.

If the total grant due at section C line (i) for the project exceeds the ‘de minimis’ level for auditor certification, please send this form to your appointed auditor and a copy to the Environment Agency grant administration team address below. If the total grant due is below the de minimis level, auditor certification is not necessary.

The organisation submitting this form CRF5 is responsible for demonstrating to its appointed auditor the reconciliation of the estimates in section C to the final approved sum, including all the approved variations.

Please send the completed form to the Environment Agency at the address below:

Business Finance – Grants Administration Team
Environment Agency
Manley House
Kestrel Way
Sowton
Exeter
EX2 7LQ

Alternatively, email it to CRFfinance@environment‐agency.gov.uk

If you are not sure about anything in this form, contact the person who sent it to you or phone us on 01392 442002.

Include an explanation if the whole or any part of the contingency sum has been used. All additional work or variations undertaken must be identified and justified if the cost for each individual item of work exceeds £10,000 or 10% of the original approved estimated cost of the scheme, whichever is the lesser. All variations must be approved prior to completion of this form or they will not be eligible for a grant.

Any overclaimed, underspent or inappropriate use of a grant is repayable to the Environment Agency forthwith and may be invoiced at any time. The Environment Agency aims to invoice any such sums by the date of approval of the final statement of account, but reserves the right to do so at a later date.

Contents

AScheme details

BCertificate of the organisation

CFinancial statement

DThe Data Protection Act 1998

ECertificate of the authority

FOrganisation’s bank details

GAudit certificate

CRF5 Version 1, June 2012page 1 of 4

Form CRF5: Catchment Restoration Fund for England –Final statement of account

AProject details

Name of organisation

Name of project

Scheme number

Address of registered office/principal place of business

Please specify the percentage grant rate of the project (see line (i) overleaf).

%

BCertificate of the organisation

For completion by the authorised Technical Officer.

It is certified that this scheme has been completed in accordance with the plans and specifications approved by the Environment Agency.

Signature

Name (in BLOCK LETTERS)

Title (Mr, Mrs, Miss and so on)
First name
Last name
Position
Today’s date (DD/MM/YYYY)
Status

CFinancial statement

For completion by the authorised Finance Officer.

Type / Approved cost
£ / Total final expenditure
£ / Breakdown of final expenditure
£
(a)Direct costs
Staff salaries/costs
Material, equipment and machinery
Travel, accommodation and subsistence
Meetings and conferences
Compensation payments
Others, please specify
(b)External expertise
Contractors
Professional fees (audit, consultancy etc.)
Others, please specify
(c)Indirect costs
Rent
Utilities
Insurance
Others, please specify
(d)Others
Irrecoverable VAT
Others, please specify
(e)Total
(f)Less deductible contributions received or receivable
Please specify
(g)Less non‐approved cost increases and approved project items not eligible for grant
Please specify
(h)Net expenditure (eligible for grant) (e – f – g)
(i)Total grant due for the projects
(h x percentage grant rate, as stated in section A)

DThe Data Protection Act 1998

We, the Environment Agency, will process the information you provide so that we can:

  • deal with your application;
  • make sure you keep to the conditions of the licence, permit or registration;
  • process renewals; and
  • keep the public registers up to date.

We may also process or release the information to:

  • offer you documents or services relating to environmental matters;
  • consult the public, public organisations and other organisations (for example, the Health and Safety Executive, local authorities, the emergency services, the Department for Environment, Food and Rural Affairs) on environmental issues;
  • carry out research and development work on environmental issues;
  • provide information from the public register to anyone who asks;
  • prevent anyone from breaking environmental law, investigate cases where environmental law may have been broken, and take any action that is needed;
  • assess whether customers are satisfied with our service, and to improve our service; and
  • respond to requests for information under the Freedom of Information Act 2000 and the Environmental Information Regulations 2004 (if the Data Protection Act allows).

We may pass the information on to our agents or representatives to do these things for us.

ECertificate of the organisation

For completion by the Finance Officer.

I certify that:

  • the particulars in the financial statement at section C are correct;
  • the conditions set out in the Grant Conditions and CRF Guide relating to grants have been observed;
  • all sums received and receivable against the cost of this scheme have been fully identified;
  • the expenditure has been properly incurred and has not been nor will not be the subject of any other claim from other funding bodies; and
  • the application is accordingly made for any balance of grant, which may be due in respect of this project.

Without prejudice to any other rights and remedies of the Environment Agency, a false or inaccurate statement can lead to loss of entitlement and recovery of any payments made.

I declare that as far as I know and believe the information in this application is true. I understand that this application may be refused, or approval withdrawn, if I give false or incomplete information.

Signature

Name (in BLOCK LETTERS)

Title (Mr, Mrs, Miss and so on)
First name
Last name
Organisation
Position

Contact numbers, including the area code

Phone
Fax
Mobile
Email
Today’s date (DD/MM/YYYY)

FOrganisation’sbank details

Any balance of grant payable in respect of this claim will be paid to the organisation’s bankers.If changes are required to the organisation’s bank details, these should be notified to the Business Finance – Grants Administration Team, Environment Agency, Manley House, Kestrel Way, Sowton, Exeter, EX2 7LQ.These changes should be sent in a letter signed by your authorised Finance Officer.

GAudit certificate

Certificate of public auditor appointed by the organisation.

I/we have examined the entries in this form (which replaces or amends the original submitted to me/us by the organisation dated

(DD/MM/YYYY)) / and the related accounts and records of the organisation in accordance with

with certification instruction CRF‐A1 and I/we have:

  • assessed the control environment for the preparation of this claim or return in accordance with certificate instruction (CRF‐A1) and, on the basis of my/our assessment, carried out tests in the control list (CRF‐A2) and obtained such evidence and explanations as I/we consider necessary(except for the matters raised in the attached qualification letter dated

(DD/MM/YYYY)).
  • I/we have concluded that the claim or return is in accordance with the underlying records and is:

accurate and fairly stated; and

in accordance with the Grant Conditions and CRF Guide.

Signature

Name (in BLOCK LETTERS)

Title (Mr, Mrs, Miss and so on)
First name
Last name
On behalf of the
Today’s date (DD/MM/YYYY)
For Environment Agency use only
Scheme number
Date received (DD/MM/YYYY)

CRF5 Version 1, June 2012page 1 of 4